CN104042376B - 具有膨胀环的编织支架和递送方法 - Google Patents
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Abstract
本发明公开了一种自膨胀编织支架,所述自膨胀编织支架包括添加到所述支架主体的远端的至少一个远侧径向膨胀环,以增强展开所述支架时所述自膨胀编织支架的径向膨胀力,并有利于通过芯推进线材推进所述支架穿过递送护套。将近侧径向膨胀环任选地添加到所述支架主体的近端以使得能够在通过回缩所述芯推进线材部分展开之后,在完全展开所述支架主体的近侧部分之前重新捕获所述支架。
Description
背景技术
本发明整体涉及为治疗脉管系统中的缺损而用于介入性治疗处理或脉管手术的装置,更具体地讲,涉及用于将自膨胀编织支架递送到患者脉管系统中的治疗部位的系统和方法。
支架是插入到血管中以在血管内提供开放路径的管状加强件,其已广泛用于闭塞的心脏动脉的血管内血管成形术治疗。在此类应用中,支架于血管成形术等手术之后插入以防止动脉再狭窄。在这些应用中,支架通常用充气式囊或迫使支架打开的机械装置展开,从而在血管成形术之后增强动脉壁并在动脉中心形成畅通路径以防止再狭窄。
虽然此类方法在使用血管闭塞装置的血管手术的某些方面中是有用的,但神经脉管的脆弱性和曲折性限制了此类支架在用于修复神经血管缺损的手术中的适应性。此外,使用的放置技术,例如通常认为在心脏手术中有用的那类球囊或机械膨胀在血管闭塞手术中,尤其是在治疗微小血管(例如在大脑中发现的那些)时的用处相对较小。因此,本领域的技术人员已经认识到需要与神经血管缺损的血管闭塞治疗中的技术相兼容的支架,该支架在神经血管缺陷的附近进行选择性的增强,同时避免对血管造成任何不必要的创伤或破裂风险。
通常由多个细长构件,例如两根或更多根金属丝,或聚合物纤维或材料线形成的编织支架在(例如)神经血管缺陷的治疗中可以是非常有用的。然而,在体腔内展开自膨胀编织支架的其中一个问题是激活初始膨胀端(通常为编织支架的远端)使其完全打开。重要的是,初始膨胀端应方便快速地完全打开,以使得可使用初始膨胀端作为锚定点来展开自膨胀编织支架的剩余长度。
由编织线材制成的支架通常还具有高的内摩擦力,该内摩擦力可抵抗自膨胀编织支架打开时的固有径向膨胀力,尤其可抵抗初始膨胀端的打开,这可导致在锚定和展开此类自膨胀编织支架时出现问题。展开编织支架的另一个常见问题是难以通过递送护套或微导管推进压缩或卷曲的编织支架,这通常也归因于编织支架与递送护套或微导管之间的摩擦力。编织支架的传统递送系统通过抵靠着编织支架的近端推进钝面从而在远侧方向上推动编织支架,因此,施加到编织支架的近端的力往往会轴向压缩编织支架,从而导致编织支架径向膨胀。因此,当编织支架在递送护套或微导管内膨胀时,增加的法向力施加到递送护套或微导管的内表面,从而增加了编织支架与递送护套或微导管之间的摩擦力。
目前的自膨胀编织支架通常仅基于它们的材料、尺寸、单元设计和内摩擦力进行膨胀。此类自膨胀编织支架的展开通常需要用户进行额外的操作以完全打开自膨胀编织支架,这影响了放置精度并增加了手术风险。对于后续适当地对齐和定位支架主体的剩余部分而言,适当地展开和固定自膨胀编织支架的初始展开端或远端是必要的。
展开自膨胀编织支架的另一个问题涉及难以在支架部分展开之后和支架完全展开之前重新捕获自膨胀编织支架。目前,通常将自膨胀编织支架推进穿过递送护套或微导管直至自膨胀编织支架露出。当自膨胀编织支架在套管或微导管的外面不受限制时,自膨胀编织支架通常于之后进行膨胀并在脉管系统中展开,从而难以重新捕获自膨胀编织支架。
希望提供这样一种改进的自膨胀编织支架,该改进的自膨胀编织支架,尤其是在初始展开端或远端处具有增强的径向膨胀力,还可以减小穿过递送护套或微导管递送编织支架过程中编织支架的内摩擦力,以用于提高展开自膨胀编织支架,尤其是在自膨胀编织支架的初始展开端或远端处的简易性和可靠性。还希望提供这样一种改进的自膨胀编织支架,该改进的自膨胀编织支架可在部分展开自膨胀编织支架的远侧部分之后、完全展开自膨胀编织支架的后展开部分或近侧部分之前被重新捕获。本发明可满足这些以及其他需要。
发明内容
简而言之,本发明提供了具有一个或多个膨胀环的改进的自膨胀编织支架和穿过递送护套或微导管将自膨胀编织支架递送到患者脉管系统中的治疗部位的方法。本发明提供了向自膨胀编织支架的初始展开端或远端添加至少一个径向膨胀环以提高自膨胀编织支架的径向膨胀力,从而提高展开自膨胀编织支架的简易性和可靠性,尤其是在展开自膨胀编织支架过程中更可靠地膨胀和固定自膨胀编织支架的初始展开端或远端。向自膨胀编织支架的后展开端或近端添加径向膨胀环能够在部分展开自膨胀编织支架的远侧部分之后和完全展开自膨胀编织支架的后展开部分或近侧部分之前重新捕获自膨胀编织支架。
因此,在第一实施例中,本发明提供了编织支架,该编织支架包括由多个细长构件形成的管状编织支架主体,以及设置在管状编织支架主体的近端和远端中的至少一者中并固定地连接至管状编织支架主体的近端和远端中的至少一者的一个或多个膨胀环。在本发明的一个优选的方面,一个或多个膨胀环具有压缩构型和膨胀构型,所述压缩构型具有第一直径,所述膨胀构型具有大于第一直径的第二直径。在本发明的另一个优选的方面,多个细长构件可由多根金属丝、多根聚合物纤维、多根材料线等形成。在本发明的另一个优选的方面,编织支架为具有压缩构型和膨胀构型的自膨胀支架,所述压缩构型具有未膨胀的直径,所述膨胀构型具有大于第一直径的膨胀直径。
在本发明的另一个优选的方面,一个或多个膨胀环包括多个细长的连接臂构件,该细长的连接臂构件具有位于一个或多个膨胀环的第一末端处的第一末端和位于膨胀环的第二末端处的第二末端,并且多个细长的连接臂构件(例如)以锯齿构型交替地在第一末端和第二末端处依次连接至多个细长的连接臂构件中相邻的那些,从而在第一末端和第二末端处形成多个交替的弯头连接。在本发明的另一个优选的方面,一个或多个膨胀环由(例如)在膨胀构型中具有形状记忆位置的形状记忆材料形成,例如镍钛合金或形状记忆聚合物。优选地对一个或多个膨胀环进行热处理,使得形状记忆位置为膨胀的锯齿型环,并且多个细长的连接臂构件和交替的弯头连接优选地被配置成在递送过程中被压缩为小的管状形状。在本发明的另一个优选的方面,一个或多个膨胀环包括连接至位于一个或多个膨胀环的第一末端处的多个交替的弯头连接的多个附接凸片,并且优选的是,在一个或多个膨胀环的第一末端处的多个交替的弯头连接具有背离多个细长的连接臂构件的外端,并且多个附接凸片连接至位于一个或多个膨胀环的第一末端处的多个交替的弯头连接的外端。优选地通过(例如)将附接凸片熔接、焊接或胶接至膨胀环来将多个附接凸片固定地附接到管状编织支架主体。作为另外一种选择,附接凸片可在其中包括孔,使得线圈可螺纹穿过附接凸片,并穿过编织支架的间隙以将附接凸片和编织支架连接在一起。此外,在膨胀环的每个弯头的末端处可包括两个或更多个附接凸片,然后可使用附接凸片捕获编织支架在附接凸片之间的部分,之后可将两个或更多个附接凸片固定在一起以通过熔接、焊接、粘接等方式永久地固定到编织支架。在本发明的另一个优选的方面,膨胀环设置在管状编织支架主体的初始展开端或远端中并固定地连接至管状编织支架主体的初始展开端或远端,并且近侧膨胀环还可任选地设置在管状编织支架主体的后展开端或近端中并固定地连接至管状编织支架主体的后展开端或近端。
在本发明的另一个优选的方面,提供了芯推进线材,该芯推进线材设置在管状编织支架主体的腔和远侧膨胀环的腔中并延伸穿过管状编织支架主体的腔和远侧膨胀环的腔,并且当提供近侧膨胀环时,芯推进线材还延伸穿过近侧膨胀环的腔,从而穿过递送护套或微导管将自膨胀支架递送并释放至患者脉管系统中的治疗部位。芯推进线材优选地包括近侧部分、远侧部分、位于芯推进线材的近侧部分和远侧部分之间的中间部分,以及定位在芯推进线材的远侧部分和中间部分之间的止动构件。在本发明的一个优选的方面,止动构件由芯推进线材的扩大部分形成,该芯推进线材的扩大部分具有如下直径,所述直径大于或等于膨胀构件的压缩构型的第一直径。在本发明的另一个优选的方面,止动构件被配置成在朝远侧推进芯推进线材时接合远侧膨胀环的近侧内侧,从而穿过远侧膨胀环将朝远侧施加到芯推进线材的力传递至编织支架的初始展开端或远端并起到朝远侧拖动和拉长编织支架的作用。编织支架通常被配置成穿过递送护套或微导管递送,并且当朝远侧向芯推进线材施加力时,芯推进线材优选地被配置成减小编织支架与递送护套或微导管之间的摩擦力。
在本发明的另一个优选的方面,当提供近侧膨胀环时,芯推进线材包括芯推进线材上的中间止动构件,该中间止动构件定位在第二膨胀环远侧的编织支架的腔中的芯推进线材的中间部分上。在本发明的一个优选的方面,中间止动构件包括芯推进线材的扩大部分,该芯推进线材的扩大部分具有如下直径,所述直径大于或等于第二膨胀构件的压缩构型的第一直径。
在本发明的另一个优选的方面,本发明提供了一种穿过递送护套或微导管将自膨胀支架递送并释放至患者脉管系统中的治疗部位的方法,该方法包括以下步骤:朝远侧推动芯推进线材,使得远侧止动构件接合远侧膨胀环的近侧内侧,从而穿过远侧膨胀环将朝远侧施加到芯推进线材的力传递至管状自膨胀编织支架的初始展开端或远端,以起到拖动和拉长管状自膨胀编织支架的作用,并在朝远侧向芯推进线材施加力时,减小管状自膨胀编织支架与递送护套或微导管之间的摩擦力。在本发明的另一个优选的方面,该方法包括以下步骤:朝远侧拖动递送护套或微导管的管状自膨胀编织支架的远侧膨胀构件,同时使管状自膨胀编织支架的近侧膨胀构件保持在递送护套或微导管内;向近侧回缩芯推进线材,使得中间止动构件接合近侧膨胀环的远侧内侧;将管状自膨胀编织支架的初始展开端或远端回缩至递送护套或微导管内,使得管状自膨胀编织支架的远侧膨胀构件和初始展开端或远端的直径减小;以及重新捕获递送护套或微导管内的管状自膨胀编织支架。
本发明的这些以及其他特征和优点将由于以下参照附图对优选实施例作的详细说明而更加明显,这些实施例以举例方式说明本发明的作用。
附图说明
图1为根据本发明的被配置成附连在编织支架内的膨胀环的透视图。
图2为根据本发明的附连在编织支架的初始展开端或远端内的图1膨胀环的示意性剖视正视图,该编织支架被示出包含在递送护套或微导管内。
图3为类似于图2的示意性剖视正视图,示出了图2的递送护套或微导管中的编织支架的初始展开端或远端的部分展开。
图4为根据本发明的附连在编织支架的初始展开端或远端内的图1膨胀环的示意性剖视正视图,该编织支架被示出为包含在递送护套或微导管内,并且包括延伸穿过编织支架和膨胀环的推进线材。
图5为类似于图4的示意性剖视正视图,示出了图4的递送护套或微导管中的编织支架的初始展开端或远端的部分展开。
图6为根据本发明的编织支架的示意性剖视正视图,该编织支架具有附连在编织支架的远端和近端内的远侧膨胀环和近侧膨胀环,并被示出为包含在递送护套或微导管内,并且该编织支架包括延伸穿过编织支架和膨胀环的推进线材。
图7为类似于图6的示意性剖视正视图,示出了图6的递送护套或微导管中的编织支架的初始展开端或远端的部分展开。
图8为类似于图6的示意性剖视正视图,示出了图6的递送护套或微导管中的编织支架的初始展开端或远端的回缩。
图9为类似于图6的示意性剖视正视图,示出了编织支架在患者脉管系统中的治疗部位处的植入,以及推进线材和递送护套或微导管的回收。
具体实施方式
虽然通常已用充气式囊或迫使支架打开的机械装置在例如闭塞的心脏动脉的血管内血管成形术治疗过程中将支架递送到血管内,但神经脉管的脆弱性和曲折性限制了此类支架在用于修复神经血管缺损的手术中的适用性,因此希望提供一种改进的自膨胀编织支架,该改进的自膨胀编织支架,尤其是在初始展开端或远端处具有增强的径向膨胀力,还可以减小穿过递送护套或微导管递送编织支架过程中编织支架的内摩擦力,可以更可靠地在自膨胀编织支架的初始展开端或远端处膨胀和固定,并可以在部分展开自膨胀编织支架的远侧部分之后、完全展开自膨胀编织支架的后展开部分或近侧部分之前被重新捕获。
因此,参见以举例的方式提供而不具有限制性目的的附图,在第一实施例中,对于患者脉管系统的治疗而言,本发明提供了编织支架10,该编织支架包括管状编织支架主体11,该管状编织支架主体具有后展开端或近端12、初始展开端或远端14和内腔16。管状编织支架主体优选地由多个细长构件18形成,例如通常由两根或更多根金属丝,或聚合物纤维或材料线形成。在本发明的一个优选的方面,编织支架为自膨胀支架,并且包括一个或多个膨胀环20,每个膨胀环具有第一末端22、第二末端24和内腔26。一个或多个膨胀环优选地设置在管状编织支架主体的至少初始展开端或远端中并固定地连接至管状编织支架主体的至少初始展开端或远端,但一个或多个膨胀环也可设置在管状编织支架主体的后展开端或近端中并固定地连接至管状编织支架主体的后展开端或近端,如将在下文进一步说明。
每个膨胀环包括多个细长的连接臂构件30,该细长的连接臂构件具有位于膨胀环的第一末端处的第一末端32和位于膨胀环的第二末端处的第二末端34。将多个细长的连接臂构件交替地在第一末端和第二末端处依次连接至多个细长的连接臂构件中相邻的那些,从而在膨胀环的第一末端和第二末端处形成多个交替的弯头连接36,以使得每个膨胀环的多个细长的连接臂构件基本上具有锯齿构型。
参见图3和4,每个膨胀环优选地被形成为具有压缩构型38和膨胀构型42,所述压缩构型具有第一直径,所述膨胀构型具有大于膨胀环的压缩构型的第一直径的第二直径。每个膨胀环优选地由(例如)在膨胀构型中具有形状记忆位置的形状记忆材料形成,例如镍钛合金或形状记忆聚合物。例如,可对膨胀环进行适当的热处理,使得膨胀环形成为所需的膨胀形状记忆位置的形状,其中多个细长的连接臂构件具有基本上锯齿型的构型。每个膨胀环通常通过(例如)适当的激光器通过切割由诸如镍钛合金或形状记忆聚合物的形状记忆材料形成的管而形成。优选地可将压缩构型中的多个细长的连接臂构件和交替的弯头连接压缩为管状形状,该管状形状足够小以适当地装配在递送护套或微导管44中并穿过递送护套或微导管44,从而允许穿过递送护套或微导管递送支架。
在本发明的另一个优选的方面,每个膨胀环包括多个附接凸片46,该多个附接凸片连接至位于膨胀环的第一末端处的多个交替的弯头连接。多个附接凸片优选地连接至位于一个或多个膨胀环的第一末端处的多个交替的弯头连接的外端48。优选地通常通过(例如)熔接、焊接或例如通过适当的粘合剂胶接,在管状编织支架主体的远端或近端处或附近将多个附接凸片固定地连接至管状编织支架主体。作为另外一种选择,附接凸片可在其中包括孔,使得线圈可螺纹穿过附接凸片,并穿过编织支架的间隙以将附接凸片和编织支架连接在一起。此外,在膨胀环的每个弯头的末端处可包括两个或更多个附接凸片,然后可使用附接凸片捕获编织支架在附接凸片之间的部分,之后可将两个或更多个附接凸片固定在一起以通过熔接、焊接、粘接等方式永久地固定到编织支架。至少一个第一远侧膨胀环20a优选地设置在管状编织支架主体的初始展开端或远端中并固定地连接至管状编织支架主体的初始展开端或远端。如图6-9所示,第二近侧膨胀环20b还优选地设置在管状编织支架主体的后展开端或近端中并固定地连接至管状编织支架主体的后展开端或近端。
参见图4-9,在第二实施例中,其中相同的附图标号代表相同的元件,本发明还提供了设备50,该设备用于穿过递送护套或微导管将自膨胀编织支架递送并释放至患者脉管系统52中的治疗部位。该设备包括具有上述管状编织支架主体的编织支架,还包括芯推进线材54,该芯推进线材设置在管状编织支架主体的腔中并延伸穿过管状编织支架主体的腔,并设置在远侧膨胀环20a的腔中并延伸穿过远侧膨胀环20a的腔,该远侧膨胀环固定地连接在管状编织支架主体的初始展开端或远端内。如图6-9所示,当近侧膨胀环20b固定地连接在管状编织支架主体的后展开端或近端内时,芯推进线材还设置在近侧膨胀环的腔中并延伸穿过近侧膨胀环的腔。
芯推进线材包括近侧部分56、远侧部分58、位于芯推进线材的近侧部分和远侧部分之间的中间部分60,以及定位在芯推进线材的远侧部分和中间部分之间的远侧止动构件62。在本发明的一个优选的方面,如图4所示,远侧止动构件形成为芯推进线材的扩大部分,该芯推进线材的扩大部分具有如下直径,所述直径大于或等于膨胀构件的压缩构型的第一直径。远侧止动构件优选地被配置成在朝远侧推进芯推进线材时接合远侧膨胀环的近侧内侧64,使得在穿过递送护套或微导管将编织支架递送至治疗部位时,穿过远侧止动构件将朝远侧施加到芯推进线材的力传递至远侧膨胀环,并因此传递至编织支架的初始展开端或远端,从而起到在远侧方向上拖动编织支架的作用,并起到拉长编织支架的作用,还有利地减小了编织支架与通过其递送编织支架的递送护套或微导管的摩擦力。
在另一个优选的方面,还可以提供位于芯推进线材上的近侧止动构件66,该近侧止动构件定位在编织支架的近端的外侧和近侧。当提供了近侧止动构件时,该近侧止动构件优选地具有如下直径,所述直径大于或等于编织支架的压缩构型的未膨胀直径且小于递送护套或微导管的直径。
可通过朝远侧(朝如图所示的左侧)推进芯推进线材从而穿过递送护套或微导管将自膨胀编织支架递送并释放至患者脉管系统中的治疗部位,以使得芯推进线材的远侧止动构件接合远侧膨胀环的近侧内侧。由于远侧膨胀环附接到编织支架,因此穿过远侧膨胀环将朝远侧施加到芯推进线材的力传递至编织支架的初始展开端或远端,并且在远侧方向上施加到编织支架的初始展开端或远端的力因此往往会拖动和拉长支架,从而减小编织支架的压缩构型的直径,并减小编织支架与递送护套或微导管之间的摩擦力。
在图6-9所示的另一个实施例中,其中相同的附图标号代表相同的元件,本发明还提供了用于穿过递送护套或微导管将自膨胀编织支架递送并释放至患者脉管系统中的治疗部位的设备,其中芯推进线材还包括定位在近侧膨胀环远侧的编织支架的腔中的芯推进线材的中间部分上的中间止动构件68。中间止动构件优选地被形成为芯推进线材的扩大部分,该芯推进线材的扩大部分具有如下直径,所述直径大于或等于近侧膨胀构件的压缩构型的第一直径。当芯推进线材朝近侧回缩时,中间止动构件优选地被配置成接合近侧膨胀环的远侧内侧70,从而使编织支架回缩至递送护套或微导管内。
在该实施例中,如上所述,可通过朝远侧推进芯推进线材从而穿过递送护套或微导管将自膨胀编织支架递送并释放至患者脉管系统中的治疗部位,并且也可随后朝近侧(朝如图8所示的右侧)回缩芯推进线材,使得中间止动构件接合近侧膨胀环的远侧内侧。只要编织支架未展开超过近侧膨胀环,就可以用这种方法重新捕获编织支架。穿过近侧膨胀环将朝近侧施加到递送线材的回缩力传递至编织支架的近端,并且在编织支架被重新捕获回到递送护套或微导管内时,编织支架的初始展开端或远端的直径通过套管或微导管的入口72减小,直至编织支架再次被递送护套或微导管完全包封。
根据上述内容显而易见,虽然已经图示并描述了本发明的特定形式,但是可在不背离本发明的实质和范围的情况下进行多种修改。因此,本文无意对本发明加以限制,本发明由所附权利要求书限定。
Claims (23)
1.一种编织支架,包括:
管状编织支架主体,所述管状编织支架主体具有近端、远端和内腔,所述管状编织支架主体由多个细长构件形成;
至少一个膨胀环,所述至少一个膨胀环设置在所述管状编织支架主体的所述近端和所述远端中的至少一者中并固定地连接至所述管状编织支架主体的所述近端和所述远端中的至少一者,所述至少一个膨胀环具有第一末端、第二末端和内腔,所述至少一个膨胀环具有压缩构型和膨胀构型,所述压缩构型具有第一直径,所述膨胀构型具有大于所述第一直径的第二直径,其中所述至少一个膨胀环包括多个细长的连接臂构件,所述多个细长的连接臂构件具有位于所述至少一个膨胀环的所述第一末端处的第一连接臂末端和位于所述至少一个膨胀环的所述第二末端处的第二连接臂末端,所述多个细长的连接臂构件中的每一个交替地在所述第一连接臂末端和第二连接臂末端处依次连接至所述多个细长的连接臂构件中相邻的连接臂构件,从而在所述第一末端和第二末端处形成多个交替的弯头连接;和
多个附接凸片,所述多个附接凸片连接至位于所述至少一个膨胀环的所述第一末端处的所述多个交替的弯头连接,所述多个附接凸片固定地附接至所述管状编织支架主体。
2.根据权利要求1所述的编织支架,其中所述管状编织支架主体具有压缩构型和膨胀构型,所述压缩构型具有未膨胀直径,所述膨胀构型具有大于所述第一直径的膨胀直径。
3.根据权利要求1所述的编织支架,其中所述至少一个膨胀环由在所述膨胀构型中具有形状记忆位置的形状记忆材料形成。
4.根据权利要求1所述的编织支架,其中位于所述至少一个膨胀环的所述第一末端处的所述多个交替的弯头连接具有背离所述多个细长的连接臂构件的外端,并且所述多个附接凸片连接至位于所述至少一个膨胀环的所述第一末端处的所述多个交替的弯头连接的所述外端。
5.根据权利要求1所述的编织支架,其中所述至少一个膨胀环包括设置在所述管状编织支架主体的所述远端中并固定地连接至所述管状编织支架主体的所述远端的远侧膨胀环。
6.根据权利要求5所述的编织支架,其中所述至少一个膨胀环还包括设置在所述管状编织支架主体的所述近端中并固定地连接至所述管状编织支架主体的所述近端的近侧膨胀环。
7.根据权利要求5所述的编织支架,还包括芯推进线材,所述芯推进线材设置在所述管状编织支架主体的内腔和所述远侧膨胀环的内腔中并延伸穿过所述管状编织支架主体的内腔和所述远侧膨胀环的内腔,所述远侧膨胀环的内腔设置在所述管状编织支架主体的所述远端中并固定地连接至所述管状编织支架主体的所述远端,所述芯推进线材具有近侧部分、远侧部分、位于所述芯推进线材的所述近侧部分和远侧部分之间的中间部分,以及定位在所述芯推进线材的所述远侧部分和所述中间部分之间的止动构件。
8.根据权利要求7所述的编织支架,其中所述止动构件包括所述芯推进线材的扩大部分,所述芯推进线材的扩大部分具有如下直径,所述直径大于或等于所述远侧膨胀环的所述压缩构型的所述第一直径。
9.根据权利要求7所述的编织支架,其中在朝远侧推进所述芯推进线材时,所述止动构件被配置成接合所述远侧膨胀环的近侧内侧,从而穿过所述远侧膨胀环将朝远侧施加到所述芯推进线材的力传递至所述管状编织支架主体的所述远端,从而起到拖动和拉长所述编织支架的作用。
10.根据权利要求7所述的编织支架,还包括递送护套,所述编织支架被配置成穿过所述递送护套递送,并且其中当朝远侧向所述芯推进线材施加力时,所述芯推进线材被配置成减小所述编织支架与所述递送护套之间的摩擦力。
11.一种用于穿过递送护套将自膨胀编织支架递送并释放至患者脉管系统中的治疗部位的设备,所述设备包括:
管状自膨胀编织支架主体,所述管状自膨胀编织支架主体具有近端、远端和内腔,所述管状自膨胀编织支架主体由多个细长构件形成,所述管状自膨胀编织支架主体具有压缩构型和膨胀构型;
第一膨胀环,所述第一膨胀环设置在所述管状自膨胀编织支架主体的所述远端中并固定地连接至所述管状自膨胀编织支架主体的所述远端,所述第一膨胀环具有第一末端、第二末端和内腔,所述第一膨胀环具有压缩构型和膨胀构型,所述压缩构型具有第一直径,所述膨胀构型具有大于所述第一直径的第二直径,所述第一膨胀环包括多个细长的连接臂构件,所述多个细长的连接臂构件具有位于所述第一膨胀环的所述第一末端处的第一连接臂末端和位于所述第一膨胀环的所述第二末端处的第二连接臂末端,具有锯齿构型的所述多个细长的连接臂构件中的每一个交替地在所述第一连接臂末端和第二连接臂末端处依次连接至所述多个细长的连接臂构件中相邻的连接臂构件,以在所述第一末端和第二末端处形成多个交替的弯头连接,其中所述多个细长的连接臂构件和所述交替的弯头连接被配置成在递送过程中被压缩为小的管状形状;
芯推进线材,所述芯推进线材设置在所述管状自膨胀编织支架主体的内腔和所述第一膨胀环的内腔中并延伸穿过所述管状自膨胀编织支架主体的内腔和所述第一膨胀环的内腔,所述芯推进线材具有近侧部分、远侧部分、位于所述芯推进线材的所述近侧部分和远侧部分之间的中间部分,以及定位在所述芯推进线材的所述远侧部分和所述中间部分之间的远侧止动构件,在朝远侧推进所述芯推进线材时,所述远侧止动构件被配置成接合所述第一膨胀环的近侧内侧,从而穿过所述第一膨胀环将朝远侧施加到所述芯推进线材的力传递至所述管状自膨胀编织支架主体的所述远端,并起到拖动和拉长所述管状自膨胀编织支架主体的作用,并且其中在朝远侧向所述芯推进线材施加力时,所述芯推进线材被配置成减小所述管状自膨胀编织支架主体与所述递送护套之间的摩擦力。
12.根据权利要求11所述的设备,其中所述第一膨胀环由在所述膨胀构型中具有形状记忆位置的形状记忆材料形成。
13.根据权利要求11所述的设备,还包括多个附接凸片,所述多个附接凸片连接至位于所述第一膨胀环的所述第一末端处的所述多个交替的弯头连接,其中位于所述第一膨胀环的所述第一末端处的所述多个交替的弯头连接具有背离所述多个细长的连接臂构件的外端,并且所述多个附接凸片连接至位于所述第一膨胀环的所述第一末端处的所述多个交替的弯头连接的所述外端,并且其中所述多个附接凸片固定地附接至所述管状自膨胀编织支架主体。
14.根据权利要求11所述的设备,其中所述远侧止动构件包括所述芯推进线材的扩大部分,所述芯推进线材的扩大部分具有如下直径,所述直径大于或等于所述第一膨胀环的所述压缩构型的所述第一直径,所述第一膨胀环设置在所述管状自膨胀编织支架主体的所述远端中并固定地连接至所述管状自膨胀编织支架主体的所述远端。
15.根据权利要求11所述的设备,还包括第二膨胀环,所述第二膨胀环设置在所述管状自膨胀编织支架主体的所述近端中并固定地连接至所述管状自膨胀编织支架主体的所述近端,所述芯推进线材包括位于所述芯推进线材上的近侧止动构件,所述近侧止动构件定位在所述管状自膨胀编织支架主体的所述近端的外侧和近侧,所述近侧止动构件具有如下直径,所述直径大于或等于所述管状自膨胀编织支架主体的所述压缩构型的未膨胀直径且小于所述递送护套的直径。
16.根据权利要求11所述的设备,还包括第二膨胀环,所述第二膨胀环设置在所述管状自膨胀编织支架主体的所述近端中并固定地连接至所述管状自膨胀编织支架主体的所述近端,所述芯推进线材包括位于所述芯推进线材上的中间止动构件,所述中间止动构件定位在所述第二膨胀环远侧的所述管状自膨胀编织支架主体的内腔中的所述芯推进线材的所述中间部分上。
17.根据权利要求16所述的设备,其中所述中间止动构件包括所述芯推进线材的扩大部分,所述芯推进线材的扩大部分具有如下直径,所述直径大于或等于所述第二膨胀环的所述压缩构型的所述第一直径。
18.一种用于穿过递送护套将自膨胀支架递送并释放至患者脉管系统中的治疗部位的设备,所述设备包括:
管状自膨胀编织支架主体,所述管状自膨胀编织支架主体具有近端、远端和内腔,所述管状自膨胀编织支架主体由多个细长构件形成,所述管状自膨胀编织支架主体具有压缩构型和膨胀构型;
远侧膨胀环和近侧膨胀环,所述远侧膨胀环设置在所述管状自膨胀编织支架主体的所述远端中并固定地连接至所述管状自膨胀编织支架主体的所述远端,所述近侧膨胀环设置在所述管状自膨胀编织支架主体的所述近端中并固定地连接至所述管状自膨胀编织支架主体的所述近端,所述远侧膨胀环和近侧膨胀环中的每一个具有第一末端、第二末端和内腔,所述远侧膨胀环和近侧膨胀环中的每一个具有压缩构型和膨胀构型,所述压缩构型具有第一直径,所述膨胀构型具有大于所述第一直径的第二直径,所述远侧膨胀环和近侧膨胀环中的每一个包括多个细长的连接臂构件,所述多个细长的连接臂构件具有位于所述远侧膨胀环和近侧膨胀环中的相应一个的所述第一末端处的第一连接臂末端和位于所述远侧膨胀环和近侧膨胀环中的相应一个的所述第二末端处的第二连接臂末端,具有锯齿构型的所述多个细长的连接臂构件中的每一个交替地在所述第一连接臂末端和第二连接臂末端处依次连接至所述多个细长的连接臂构件中相邻的连接臂构件,以在所述第一末端和第二末端处形成多个交替的弯头连接,其中所述多个细长的连接臂构件和所述交替的弯头连接被配置成在递送过程中被压缩为小的管状形状;
芯推进线材,所述芯推进线材设置在所述管状自膨胀编织支架主体的内腔和所述远侧膨胀环和近侧膨胀环中的每一个的内腔中并延伸穿过所述管状自膨胀编织支架主体的内腔和所述远侧膨胀环和近侧膨胀环中的每一个的内腔,所述芯推进线材具有近侧部分、远侧部分、位于所述芯推进线材的所述近侧部分和远侧部分之间的中间部分、定位在所述芯推进线材的所述远侧部分和所述中间部分之间的远侧止动构件,以及定位在所述近侧膨胀环远侧的所述管状自膨胀编织支架主体的内腔中的所述芯推进线材的所述中间部分上的所述芯推进线材上的中间止动构件,在朝远侧推进所述芯推进线材时,所述远侧止动构件被配置成接合所述远侧膨胀环的近侧内侧,从而穿过所述远侧膨胀环将朝远侧施加到所述芯推进线材的力传递至所述管状自膨胀编织支架主体的所述远端,并起到拖动和拉长所述管状自膨胀编织支架主体的作用,并且其中在朝远侧向所述芯推进线材施加力时,所述芯推进线材被配置成减小所述管状自膨胀编织支架主体与所述递送护套之间的摩擦力,并且在朝近侧回缩所述芯推进线材时,所述中间止动构件被配置成接合所述近侧膨胀环的远侧内侧,从而使所述管状自膨胀编织支架主体回缩到所述递送护套内。
19.根据权利要求18所述的设备,其中所述远侧膨胀环和近侧膨胀环中的至少一个由在所述膨胀构型中具有形状记忆位置的形状记忆材料形成。
20.根据权利要求18所述的设备,还包括多个附接凸片,所述多个附接凸片连接至位于所述远侧膨胀环和近侧膨胀环中每一个的所述第一末端处的所述多个交替的弯头连接,其中位于所述远侧膨胀环和近侧膨胀环的所述第一末端处的所述多个交替的弯头连接具有背离所述多个细长的连接臂构件的外端,并且所述多个附接凸片连接至位于所述远侧膨胀环和近侧膨胀环的所述第一末端处的所述多个交替的弯头连接的所述外端,并且其中所述多个附接凸片固定地附接至所述管状自膨胀编织支架主体。
21.根据权利要求18所述的设备,其中所述远侧止动构件包括所述芯推进线材的扩大部分,所述芯推进线材的扩大部分具有如下直径,所述直径大于或等于所述远侧膨胀环的所述压缩构型的所述第一直径。
22.根据权利要求18所述的设备,还包括位于所述芯推进线材上的近侧止动构件,所述近侧止动构件定位在所述管状自膨胀编织支架主体的所述近端的外侧和近侧,所述近侧止动构件具有如下直径,所述直径大于或等于所述管状自膨胀编织支架主体的所述压缩构型的未膨胀直径且小于所述递送护套的直径。
23.根据权利要求18所述的设备,其中所述中间止动构件包括所述芯推进线材的扩大部分,所述芯推进线材的扩大部分具有如下直径,所述直径大于或等于所述近侧膨胀环的所述压缩构型的所述第一直径。
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2013
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AU2018247301A1 (en) | 2018-11-01 |
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AU2014201193A1 (en) | 2014-10-02 |
EP3260089B1 (en) | 2021-10-20 |
EP3260089A1 (en) | 2017-12-27 |
JP2018171522A (ja) | 2018-11-08 |
US11529249B2 (en) | 2022-12-20 |
DK2777638T3 (da) | 2018-01-29 |
EP3257480A1 (en) | 2017-12-20 |
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